Resultados perinatales adversos en colestasis intrahepática del embarazo

Abstract

Objective

To describe the perinatal and maternal outcomes of patients with intrahepatic cholestasis of pregnancy (ICP) in the National Institute of Perinatology.

Material and method

A retrospective, observational study was conducted that included clinical files of women with single or multiple pregnancy with ICP between January 2012 and December 2015.

Results

A total of 25 patient files were included, 32% of whom were primiparous. On the multiparous, 2 stillbirths were recorded in their previous pregnancy (these patients had a history of ICP). The diagnosis was carried out clinically in 100% of the cases. It was then confirmed by hepatic enzyme elevation in 21 patients. Bile acids were requested for 48% of the patients, of which 67% were reported as > 10 mmol/L. One patient was classified as severe ICP (bile acids > 100 mmol/L. Around two-thirds (68%) of patients received ursodeoxycholic acid. The birth was preterm in 40% of the patients 24% were spontaneous and 16% iatrogenic, and 2 patients (8%) developed mild pre-eclampsia. There were a total of 26 newborns, as one of the patients was carrying twins. One newborn was small for gestational age. Admission to neonatal intensive care unit was required for 12% of the newborns, and 3 cases of meconium were reported. The mean Apgar score was 8/9.

Conclusion

The treatment for patients with ICP in the present hospital varies significantly. Therefore, it is essential to develop internal guidelines to homogenise the diagnosis, follow-up, and treatment of the patients.